On... The General Election #1: Sicknote Sanism
Can Mental Health Ever Go Too Far?
I’m stood in front of my two bosses in the upstairs of a tinpot tourist shop on the Damrak in Amsterdam. The Damrak is effectively Amsterdam’s version of Oxford Street, where historical prestige has been replaced with tourism-induced noxious gaudiness. The shops that line the long, straight street are the embodiment of the Disneyfication of the city, where a false cartoon image of Dutch culture is beamed into the brain's gullible stoners.
The shop sold an assortment of frivolous shite: red light district magnets, wooden clogs, clog keyrings, clog slippers, Anne Frank t-shirts, and Tulip bulbs.
It was as if the owners were taking the piss out of how stupid their customers were. Which, I suppose, they were.
I had been working there 2-3 days a week for around a month before an episode of depression began brewing in a black cauldron somewhere deep in my brain. At this point, I was 25 and had been suffering episodic depression for 8 years or so. I had failed my second year at uni, chanced my way to completing my third year, and had so much time off sick while working at the Edinburgh Woollen Mill they created a separate spreadsheet for me. I’m no amateur, as you can tell.
I was, if my memory serves me right, supposed to be working Saturday and Sunday that week. With a slight tremble of anxiety in my fingers, I called the shop to tell them I couldn’t work.
They were, much to my surprise, incredibly understanding and generous about the situation. One of the co-owners just suggested I take the weekend off and call back next week. I was genuinely elated and relieved.
The following few days saw the thick claws of the depression grip themselves tighter around my body. The symptoms were becoming relentless, and my ability to leave the house was becoming increasingly restricted. The cultural delights of Amsterdam existed only behind the glass of the long windows that mark out Dutch houses.
So I needed to call in sick again. This time, they were not understanding. They fired me over the phone, explaining that I was not “strong enough” to work in their shop.
I never did get my staff discount mug shaped like a clog.
In the age of identity politics, our cultural discourse swirls with isms and phobias: racism, sexism, ableism; homophobia, transphobia, islamophobia. All of which exist, of course; I’m not writing this dressed as The Joker holding a copy of 12 Rules for Life. But what intrigues, confounds, and often infuriates me is the lack of one word: sanism.
I imagine most people reading this will not have come across the word before. (Unless you have, then well done, you win.) Like all the other isms, it refers to an individual or structural bigotry against a specific group, in this case the mentally ill. Sanism is a long-established term in the academic world, first coined by the lawyer and physician Morton Birnbaum in 1960 and popularised by Michael L. Perlin.
However, the term has basically no existence in the public lexicon. I would go further and suggest that even the concept of bigotry against mentally ill people, whether historical or present-day, has no place within our cultural memory.
If you were to take an average member of the public and ask them about the historical crimes against black people, you are very likely to get a list of examples: slavery, lynching, maybe monkey chants at football games. I think you would get similar lists when asking people about women or LGBT people.
Would people be able to name more than one historical crime against the mentally ill? In case you yourself can’t think of any of these crimes, here are a few tasty examples:
Hydrotherapy, where patients were forced underwater in a bath until they passed out, now commonly referred to by the UN as the torture method "waterboarding," was practiced in the UK until the middle of the 20th century.
Lobotomies, in which nerves connecting the frontal lobes to other parts of the brain are severed, were performed in the UK until the 1970s. This act of violence (or surgery) turned people into walking corpses, the human equivalent of a half-rubbed-out pencil drawing. Oh, and the man who pioneered it, Antonio Moniz, was awarded a Nobel Prize in 1949.
The notorious American MKUltra illegal human experiments of the 1960s, in which people were given horrifying levels of psychedelic drugs, were conducted mostly on mentally ill people.
The sterilisation of 70,000 Americans with mental illness and neurological disabilities between the 1920s and 1970s. This eugenics programme began several years before the Nazis introduced theirs in 1934.
Pretty much every single exorcism ever performed.
How many of these have you heard of? Lobotomies are probably fairly commonly understood in their relation to mental illness, but the rest, in my opinion, languish in the rarely thumbed books on dusty shelves.
All of this leads me, in a fairly roundabout fashion, to the general election we are enduring in the UK. Even though this is probably a generational moment in British politics, given the likelihood of not just Conservative defeat but genuine annihilation, it all feels so utterly tedious. Labour will win, and probably win big, but there is no pulse of excitement surging through the country, just a kind of half-bored acceptance.
The campaign has so far been defined by dog-eared attack lines:
Labour will tax your step-aunt’s middle toe!!!
The Tories are soulless demons who the Devil would avoid on the bus.
STOP THE BOATS BY USING PLANES WHICH WON’T WORK BECAUSE RWANDA IS ACTUALLY NICER THAN SOUTHEND.
Something something “trans women in sport” something something.
We’ll save the NHS by [insert at a later date].
The usual stuff really.
Notably, while economics, as always, has been a dominant debate point, thus far benefits and the welfare system have largely gone unmentioned. Which is surprising given that in the previous few weeks the Tories were laying the groundwork for a savage attack on the UK benefits system.
It began with the comments made by Work and Pensions Secretary Mel Stride on March 24th, in which he stated that “mental health culture has gone too far.”
The MP was speaking to The Telegraph, the UK equivalent of Russia Today, about his plans to reduce the number of long-term sick workers. The Benefits Bill, set to be introduced shortly by the government, will mean people on benefits for “mild” or “common” conditions will lose their welfare support. The full list of these conditions has yet to be released, but people with “mild anxiety” will no longer be applicable.
While stressing, he was grateful that stigma around mental health had reduced. He espoused the increasingly common line that “we are labelling the normal ups and downs of human life as medical conditions that then actually serve to hold people back.”
He continued: “If they go to the doctor and say ‘I’m feeling rather down and bluesy’, the doctor will give them on average about seven minutes and then, on 94 percent of occasions, they will be signed off as not fit to carry out any work whatsoever.”
In a statement on April 22nd, the Prime Minister stated that the government’s new proposals were a “new welfare settlement for Britain." While suggesting that he will “never dismiss or downplay the illnesses people have,” he seems to do that by continuing: "It would be wrong to dismiss this growing trend [of increasing sick notes for mental health reasons]. It would be wrong merely to sit back and accept it because it’s too hard, too controversial, or for fear of causing offence.”
Sunak’s suggestion that he was happy that attitudes had changed towards mental health very much echoed the “it’s okay not to be okay” style of discourse. This drivel is meaningless because it fails to address the essential problem it is supposedly challenging: why was it not okay to be “not okay”?
Well, the reason for that is centuries of bigotry and oppression that led to the complete shunning of mentally ill people to the edges of society. Unfortunately, that doesn’t lend itself well to snappy slogans for railway posters.
The government’s rhetoric operates within the same logical failing. Sunak is happy that people can talk openly about mental illness and seek help for it, but only up to a very certain, clearly defined point. And once that ceiling is hit, it turns out that actually it is okay to not be okay, and actually those suffering maybe aren’t actually mentally ill, and you should all stop making a fuss and get on yer bike.
The arguments over labelling, the lack of nuisance in mental health discourse, false equivalences between experiences, and the detrimental effect these have are a legitimate discussion to be had. But this is not that. This is the age-old prejudice that mental illness is really just made up and repackaged once more. What happened to me in that tourist shop, when weakness and mental illness were conflated, was just plain, almost boring bigotry.
It was sanism.